Healthcare Provider Details

I. General information

NPI: 1821902156
Provider Name (Legal Business Name): LAUREN KAY ZITZOW COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 N PARK ST
NORTHWOOD ND
58267-4102
US

IV. Provider business mailing address

530 W BEND LN
ALVARADO MN
56710-4008
US

V. Phone/Fax

Practice location:
  • Phone: 701-587-6060
  • Fax:
Mailing address:
  • Phone: 218-242-7158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number202902
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number2156
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: